[Study of urinary markers of different podocytopathies by proteomic analysis].

BACKGROUND: Focal segmental glomerulosclerosis (FSGS) is a primary podocytopathy characterized by primary podocyte detection and high proteinuria. The search for biomarkers and factors associated with the progression of this disease is an important task nowdays. AIM: To assess the proteomic profile of urine in patients with FSGS and to isolate urinary biomarkers of podocytopathies. MATERIALS AND METHODS: The study included 41 patients diagnosed with chronic glomerulonephritis, 27 men and 14 women. According to the morphological study, 28 patients were diagnosed with FSGS, 9 with steroid-sensitive nephrotic syndrome and 14 with steroid-resistant nephrotic syndrome. The comparison group included 13 patients with membranous nephropathy. The study of the urinary proteome was carried out by targeted liquid chromatography-mass spectrometry using multiple reaction monitoring with synthetic stable isotope labelled peptide standards. RESULTS: The main differences in the protein profile of urine were found in the subgroups of steroid-sensitive (SS) and steroid-resistant (SR) FSGS. In the FSGS SR group, at the onset of the disease, there was a high concentration of proteins reflecting damage to the glomerular filter (apo-lipoprotein A-IV, orosomucoid, cadherin, hemopexin, vitronectin), as well as proteins associated with tubulo-interstitial inflammation and accumulation of extracellular matrix (retinol- and vitamin D-binding proteins, kininogen-1, lumican and neurophilin-2). Compared with the membranous nephropathy group, FSGS patients had significantly higher urinary concentrations of carnosinase, orosomucoid, cadherin-13, tenascin X, osteopontin, and zinc-alpha-2-glycoprotein. CONCLUSION: Thus, in patients with SR FSGS, the proteomic profile of urine includes more proteins at elevated concentrations, which reflects severe damage to various parts of the nephron compared with patients with SS FSGS and membranous nephropathy.

[The balance of proinflammatory cytokines and Treg cells in chronic glomerulonephritis].

Chronic glomerulonephritis (CGN) is a disease with a steadily progressing course, which is based on inflammation with the activation of immune cells. The severity of the inflammatory reaction in the kidney tissue is determined by the balance of locally pro-inflammatory factors and protective mechanisms, which include anti-inflammatory cytokines and T-regulatory lymphocytes (Treg). The study of processes that can modulate the severity of inflammation in the kidney is of particular interest for understanding the basic patterns of CGN progression. AIM: To determine the clinical significance of the Th17, Th1, and Treg cytokines in urine to assess the activity and progression of chronic glomerulonephritis with nephrotic syndrome (NS). MATERIALS AND METHODS: The study included 98 patients with CGN 37 women and 61 men. Patients were divided into two groups according to the degree of CGN activity. Group I consisted of 51 patients with NS. In 21 subjects, a decrease in GFR60 ml/min was revealed. Group II included 47 patients with proteinuria from 1 to 3 g/day without NS. GFR60 ml/min/1.73 m2 was observed in 26 patients. A kidney biopsy was performed in 65 patients and the hystological diagnosis was verified: 20 had mesangioproliferative GN, 16 had membranous nephropathy, 18 had focal segmental glomerulosclerosis, and 11 had membranoproliferative GN. The control group consisted of 15 healthy people. The levels of IL-6, IL-10, IL-17, tumor necrosis factor a (TNF-a) in the urine were determined using enzyme-linked immunosorbent assay. The number of FoxP3-positive cells in the inflammatory interstitial infiltrate of the cortical layer was determined in 39 patients (in a biopsy sample in a 1.5 mm2 area). RESULTS: In group of patients with CGN, there was an increase in the levels of Th17, Th1, and Treg cytokines in urine TNF-a and IL-10 compared with healthy individuals. An increase in the levels of IL-6 in the urine of patients with high clinical activity of CGN (with NS and renal dysfunction) was more pronounced than in patients with NS and normal renal function. There was a decrease in the number of Treg cells in the interstitium of the kidney and a decrease in the production of anti-inflammatory IL-10 in CGN patients with NS, compared with patients without NS. The most pronounced changes in the cytokine profile were observed in patients with FSGS with an increase in pro-inflammatory cytokines and a decrease in Treg in the kidney tissue/anti-inflammatory IL-10 in the urine. CONCLUSION: An imbalance of cytokines characterized by an increased levels of pro-inflammatory IL-17, IL-6, TNF-a, and a reduced levels of anti-inflammatory IL-10 and T-regulatory cells in the kidney tissue is noted in patients with NS, especially with FSGS. Imbalance of cytokines reflects the high activity of CGN and the risk of the progression of the disease.

[Successful treatment of a rare variant of mesangioproliferative glomerulonephritis with IgM deposits with Cyclosporin A].

We present a case with a rare variant of glomerulonephritis, IgM nephropathy, which occurs mainly with nephrotic syndrome. The clinical features of this variant of kidney damage are characterized; the pathogenetic and the transformation of this form of nephritis into focal segmental glomerulosclerosis are discussed. The development of severe nephrotic syndrome at the beginning of the disease, the formation of secondary steroid resistance have confirmed this hypothesis and have justified the treatment with cyclosporin A aimed at the recovery of the function of the podocyte with remission of nephritis.

Superfast ion scattering by solar wind discontinuities.

Large-amplitude fluctuations of the solar wind magnetic field can scatter energetic ions. One of the main contributions to these fluctuations is provided by solar wind discontinuities, i.e., rapid rotations of the magnetic field. This study shows that the internal configuration of such discontinuities plays a crucial role in energetic ion scattering in pitch angles. Kinetic-scale discontinuities accomplish very fast ion pitch-angle scattering. The main mechanism of such pitch-angle scattering is the adiabatic invariant destruction due to separatrix crossings in the phase space. We demonstrate that efficiency of this scattering does not depend on the magnetic field component across the discontinuity surface, i.e., both rotational and almost tangential discontinuities scatter energetic ions with the same efficiency. We also examine how the strong scattering effect depends on the deviations of the discontinuity magnetic field from the force-free one.

[Autoimmunity and autoinflammation in pathogenesis of immunoinflammatory diseases].

Rheumatic diseases relate to the group of the immunoinflammatory diseases (IID), in pathogenesis of which have a value both autoimmune and autoinflammatory processes. AIM: To present the heterogeneous pathogenesis of inflammation in IID. MATERIALS AND METHODS: It is inspected 260 patients (pts) with IID: 242 pts with systemic autoimmune diseases (SAD): 65 systemic lupus erythematosis, 50 systemic sclerosis, 127 systemic vasculitides (SV) and 18 patients with autoinflammatory diseases (AID): 8 Behcets disease, 2 periodic disease, 5 familial cold fever, 2 idiopathic lobular panniculitis and 1 relapsing polychondritis. Is carried out a study of complement, antigen of von Willebrand factor (FW:AG), antinuclear antibodies, antibodies to DNA, anti-endothelial antibodies, antibodies to topoizomeraze I (anti-Scl-70), antineutrophilic cytoplasmic antibodies (ANCA), anticardiolipin antibodies (aCL IgG and aCL IgM), cryoglobulins, VS, CRP. RESULTS: SAD were characterized by the synthesis of wide antibodies spectrum. As the basic serological marker at the screening it follows to consider antinuclear antibodies (75%). Practically in all groups it took place hypcomlemetemia with reduction of C3 and C4 complement. With systemic lupus erythematosis are revealed antibodies to DNA (71%), with ANCA-associated SV-ANCA (94%), aKL (14%); with SSD aScl-70 (17%). At Wegener granulomatosis ANCA are determined in 94% patients in the active stage. It is noted correlation ANCA with the index of the clinical activity of vasculitis. In the remaining SV groups ANCA were separated in the single cases. Cryoglobulins are noted in all patients with cryoglobulinemic vasculitis. aCL IgG and aCL IgM were the markers of antiphospholipid syndrome. Аnti-endothelial antibodies had significant oscillation spectrum. High indices FW:AG are noted with all above nosologic forms indicated, especially with Wegener granulomatosis and vasculitis hemorrhagic. Among the laboratory tests of inflammatory activity should be considered the determination of VS, CRP and FV:AG, which is also considered the marker of vascular wall defeat. Is given clinical characteristic and changes in the laboratory indices at AID: Conclusion.Isolation from the group IID of patients with AID serves as indication for a genetic study of this contingent with the approval of use for their treatment of biological therapy. Isolation from the group SAD patients with AID serves as indication for a genetic study of this contingent with the approval of use for their treatment of biological therapy.

[Acute appendicitis within the strangulated femoral hernia]. / Sluchai ostrogo appenditsita v ushchemlennoi bedrennoi gryzhe.

Femoral hernia strangulation is usually observed in middle-aged women. There are few case reports of appendix strangulation in the femoral hernia. Acute appendicitis in a strangulated femoral hernia is relatively rare (0.4% of cases). Clinical case of acute destructive appendicitis within a strangulated femoral hernia in an elderly woman is reported in the article. If there is doubt about the urgency of surgical intervention, surgeon needs to take a proactive stance and lean toward emergency surgery. Surgeon should be aware of possible strangulation-associated destructive appendicitis due to injury of the appendix.

[Cerebral perfusion, arterial hypertension and endothelial dysfunction in rheumatoid arthritis]. / Mozgovaia perfuziia, arterial'naia gipertenziia i éndotelial'naia disfunktsiia pri revmatoidnom artrite.

To study the relationship between cerebral perfusion with arterial hypertension (AH) and the state of endothelium in patients with rheumatoid arthritis (RA). MATERIAL AND METHODS: Seventy-eight patients with RA were divided into two groups: with- and without AH.The functional methods included ultrasonic duplex angioscanning and dopplerografy of the extracranial and intracranial arteries of the head and neck and daily 24 hour monitoring of arterial blood pressure (BP). C-reactive protein (CRP), vascular endothelial adhesion molecule type 1 (sVCAM-1), von Willebrand Factor antigen (vWF AG), interleukin-8 (Il-8), rheumatoid factor (RF) IgG, endothelin-1 (ET-1) were determined by immunoenzyme analysis and velocity of sedimentation (VS). The dysfunction of endothelium was evaluated by calculation of the number of desquamated endotheliocytes cells (DE). RESULTS: AH occurred in 46 (59%) patients. Cerebral hypoperfusion was observed in patients with RA in whom the reduction in the high-speed indices of blood flow were correlated with BP increase. There were negative correlations between the linear speed of blood flow on the common carotid arteries and average day and night systolic BP, average day and night diastolic BP, indices of time systolic BP and diastolic BP and avariability of BP. The same results were established for the intracranial arteries: inverse correlations between the linear speed on the anterior cerebral arteries and average day systolic BP. The signs of endothelial dysfunction represented by significant differences among the indices of activation of endothelium in RA patients in comparison with the control group were shown. Content of ET-1, sVCAM-1, vWF AG, Il-8, CRP was higher in RA. The number of DE was significantly higher as well. These indices showed significant differences depending on RA activity. Correlation analysis revealed that the markers of endothelium activation sVCAM-1, vWF AG were positively correlated with the indices of immune inflammation. CONCLUSION: An increase in the activity of inflammatory process in RA leads to endothelial dysfunction, which contributes to the increase in the peripheral vascular resistance of cerebral arteries, reduction in the high-speed indices of blood flow, growth of BP variability and the increase in load by pressure.

[Endothelial damage and circadian blood pressure profile in rheumatoid arthritis].

AIM: To study the influence of the state of endothelium on the daily profile of arterial pressure (AP) in patients with rheumatoid arthritis (RA). MATERIALS AND METHODS: In 70 RA pts carried out C-reactive protein (CRP), vascular endothelial adhesion molecule type 1 (sVCAM-1), antigen von Willebrand Factor (AG WF), interleukin-8 (Il-8), rheumatoid factor (RF), IgG, endotheline-1 (ET-1), number of desquamated endotheliocytes cells (DE), VS, activity of renin by immunoenzyme analysis. The dysfunction of endothelium was evaluated by calculation of DE. The functional methods included the daily monitoring of arterial pressure (AP). RESULTS: Arterial hypertension (AH) occurred in 40 (57.1%) pts. RA pts are revealed the signs of endothelial dysfunction, about which significant differences among the indices of activation of endothelium in comparison with control group testify. ET-1, sVCAM-1, vWF AG, Il-8, CRP content was higher in RA pts. Reliably above there was a number of DE. Reliable differences according to these indices depending of RA activity were discovered. With conducting of correlation analysis it is revealed, that markers of the activation of endothelium: sVCAM-1, vWF AG positively correlated with increasing RF IgG and indices of the immune inflammation: CRP, and DE number. In patients suffering from RA, showed signs of endothelial dysfunction. The positive correlation between endothelial damage and daily profile of AP show the relationship of these processes. CONCLUSION: Positive correlations between the damage of endothelium and disturbance of AP daily profile testify about the interrelation of these processes.

[Clinical and pathologic features of nephropathy with C1q deposits].

AIM: To determine the frequency, clinical and morphological features of a nephropathy with C1q deposits in chronic glomerulonephritis adult patients. MATERIALS AND METHODS: 296 specimens of kidneys of patients with a chronic glomerulonephritis (CGN) from 2014 for 2018 were analyzed. At the first step, specimens with C1q deposits in glomeruli revealed by immunofluorescent method were chosen. Lupus nephritis and primary membranoproliferative glomerulonephritis were exclusion criteria. At the second step, the retrospective analysis of the clinical characteristics was carried out. RESULTS AND DISCUSSION: Deposits of C1q in kidneys at 12 of 296 (4.05%) CGN were revealed, m:f ratio 2:1. Average age of the beginning of a disease was 32.1±14.7 years. At a morphological research in 8 membranous nephropathy (MN), in 2 mesangioproliferative glomerulonephritis (MesPGN), in 2 - nephrosclerosis was revealed. Among 12 patients in 5 the disease debuted a nephrotic syndrome, at the others - a proteinuria from 0.5 to 4.0 g/days with the subsequent formation of a nephrotic syndrome. In 5 of 12 patients the disease was characterized by a favor course with preserved kidney function. At 7 patients at the time of inspection decrease in function of kidneys [glomerular filtration rate (eGFR) 31 (30-34) ml/min] was noted. 5 had slow progressing of a renal failure. 2 of 12 progressed to renal failure (eGFR to 19 and 24 ml/min) within a year. CONCLUSION: Deposits of C1q in kidney were revealed in 4.05% of biopsy specimens in CGN. The most frequent morphological form was the membranous nephropathy. The clinical course was characterized by a nephrotic syndrome, more than at a half of patients - with renal dysfunction.

[Markers of endothelial activation in rheumatoid arthritis].

AIM: To study relationships between endothelial activation parameters and inflammatory activity markers in patients with rheumatoid arthritis (RA). SUBJECTS AND METHODS: Fifty-three RA patients aged 19 to 62 years were examined. A control group comprised 28 apparently healthy individuals. The markers of endothelial activation, the parameters of RA activity, and their relationship were studied. RESULTS: There was an elevation in the level of interleukin-8 (IL-8) to 413 (295; 547) pg/ml as compared to the control group 208 (207; 212) pg/ml. In the RA group, the concentration of soluble vascular cell adhesion molecule 1 (sVCAM-1) increased up to 1929 (1297.6; 2739.6) ng/ml whereas in the control group it was 750 (734; 762) ng/ml (p < 0.001). In the patients with RA, the concentration of von Willebrand factor antigen (vWFAg) reached 1.4 (0.8; 1.9) IU/ml; in the control group, it was 0.6 (0.3; 0.8) IU/ml. In the RA group, the level of desquamated endotheliocytes (DE) was higher than that in the control group. Positive correlations were found between the markers of vascular endothelial activation and those of inflammation. There was a positive correlation between C-reactive protein (CRP), rheumatoid factor (RF), sVCAM-1, and DE. Significant positive correlations were observed between DAS28 and the inflammatory markers RF and CRP (R = 0.66; p < 0.05 and R = 0.4; p < 0.05) and the endothelial activation markers sVCAM-1 and vWFAg (R = 0.8; p < 0.05 and R = 0.3; p < 0.05, respectively). CONCLUSION: The patients with RA had elevated IL-8, sVCAM-1, and vWFAg levels. Enhanced RA activity resulted in endothelial damage.

[Methotrexate-induced changes in the concentration of antibodies to mutaded citrullinated vimentin in blood serum of patients with rheumatoid arthritis].

AIM: To study effects of methotrexate on the titer of antibodies to mutated citrullinated vimentin (anti-MCV) and ascertain possibility of using this marker for control of treatment results and choice of individual effective dose of the drug. MATERIAL AND METHODS: A 12-month trial included 76 patients with verified rheumatoid arthritis (RA). Methotrexate per os was given in a dose 7.5-10 mg/week to 44 (57.9%) patients, 25 patients received no basic therapy. Anti-MCV (IU/ml) were detected with commercial chemicals made in Germany (ORGENTEC). RESULTS: RA patients given methotrexate doses 7.5 and 10 mg/week and untreated with basic anti-inflammatory drugs showed no significant differences by basic clinical and device parameters, level of anti-MCV at primary examination and 12 months later. CONCLUSION: Anti-MCV titer cannot be used for control of efficacy of methotrexate treatment in doses 75 and 10 mg/week, choice of individual effective doses.

[Anticitrullin antibodies--modern markers of rheumatoid arthritis].

Modern diagnosis of rheumatoid arthritis (RA) is based on the ARA criteria with seropositivity detection by the rheumatoid factor (RF). In a clinically evident stage of the disease this factor is highly sensitive and specific (about 90%), but in early RA efficacy of this diagnosis is considerably less. RF-IgM phenotype has limitation: frequent detection of this factor in the absence of RA and unstability of RF-IgM phenotype. Therefore, it is necessary to search for new serological criteria of RA diagnosis at early stage of the disease. Proteins containing citrullin appear only in the course of posttranslation modification of arginin residues. This fact gave rise to an original, available for clinical practice method of enzyme immunoassay for detection of antibodies to cyclic citrullinized (ACCP)--filaggrin derivative with synthetic cyclic citrullinized peptide serves as antigenic substance. According to the results of different studies, ACCP specificity in early RA diagnosis is more than 80%, combination of ACCP with ESR, RF-IgM, CRP, morning stiffness--more than 90%. As specificity of combination of these autoantibodies is almost 100%, their simultaneous determination is indicated in patients with undifferentiated arthritis for specification of the diagnosis. ACCP and antibodies to modified citrullinized vimentin (AMCV) significantly correlate with RA activity, are prognostic factors of rapidly progressive course and can be used for the disease prognosis at its early stage. Present-day data on comparative specificity and sensitivity of ACCP and AMCV are not certain and need further study.

Regulation of acid phosphatase in reverse micellar system by lipids additives: structural aspects.

Reverse micelles system is suggested as a direct tool to study the influence of membrane matrix composition on the activity and structure of membrane-associated enzymes with the use of acid phosphatase (AP) as an example. In reverse micelles the functioning of the monomeric and dimeric forms of AP could be separately observed by variation of the size of the micelles. We found that including the lipids into the micellar system can dramatically affect the enzyme functioning even at low lipid content (2% w/w), and this effect depends on the lipid nature. Structural studies using CD spectroscopy and DLS methods have shown that the influence of lipid composition on the enzyme properties might be caused by the interaction of lipids with the enzyme as well as by the influence of lipids on structure and properties of the micellar matrix.

[Brachial artery responsiveness in patients with systemic lupus erythematosus and scleroderma systematica].

AIM: to evaluate brachial artery (BA) endothelial vasomotor function in patients with systemic lupus erythematosus (SLE) and scleroderma systematica (SDS), by using noninvasive studies. Subjects and methods. Sixty-five patients, including 25 with SLE, 20 with SDS, and 20 with atherosclerosis (AS) obliterans of lower extremity peripheral arteries, were examined. A control group consisted of 30 apparently healthy individuals matched with the study groups for gender and age. The ultrasound technique described by D. Celermajer, et al. was employed to evaluate endothelium-dependent vasodilation (EIVD). Endothelium-independent vasodilation (EIVD) was assessed by the nitroglycerin test. The coefficient of BA susceptibility (CS) to reactive hyperemia was calculated. RESULTS: In all study patient groups EDVD values were significantly lower (7.3 +/- 1.35% in SLE, 6.91 +/- 0.9% in SDS, and Z7.64 +/- 1.9% in AS; p < 0.05) than in the controls (11.23 +/- 1.1%). An adequate vascular bed response was found in 5 (20%) patients with SLE and in 2 (10%) patients with SDS. A paradoxical vasoconstrictor response to reactive hyperemia was encountered in 9 (36%) patients with SLE, 11 (55%) with SDS. In all the study groups, the patients had normal EIVD with lower CS. In SLE and SDS, CS was decreased than that in the controls. The impaired BA responsiveness in SLE and SDS significantly correlated with the duration and activity of the disease, Raynaud's syndrome, capillaritides, mean blood pressure, renal lesions, as well as with the laboratory values of the activity of inflammation and blood lipid composition. CONCLUSION: In SLE and SDS, there was a reduction in EDVD and EIVD, as well as paradoxical vasoconstriction. CS is an independent indicator of endothelial dysfunction with the normal values of EIVD. Impaired BA responsiveness was associated with the course of systemic inflammation and severe lesion of organs.

[Endothelial vasomotor dysfunction in some forms of systemic vasculitis].

AIM: To study vascular endothelium in patients with systemic vasculitis (SV) with non-invasive methods. MATERIAL AND METHODS: A total of 65 SV patients entered the trial: 20 patients with Henoch-Schonlein purpura (HSP), 20 patients with thromboangitis obliterans (TO), 10 patients with polyarteritis nodosa (PN), 15 patients with Takayasy's arteritis (TA). The control group consisted of 30 subjects. Endothelium-dependent vasodilation (EDV) was assessed with the ultrasonic technique by D. Celermajer et al., endothelium-independent vasodilation (EIV)--with a nitroglycerin test. The coefficient of sensitivity (CS) of the brachial artery to reactive hyperemia was calculated. RESULTS: In all SV forms EDV was reduced. Three types of response to the tests were registered: normal (24.6%), insufficient (41.6%) and paradoxical (33.8%). Changes in EDV and EIV were revealed: in HSP--a moderate decrease of EDV and EIV; in TA--affection of EDV with frequent paradoxical reactions and noticeable decrease of EIV; in PN--a moderate decrease of EDV and affection of EIV; in TO--affection of EDV and unaffected EIV In SV patients CS was reduced even in patients with normal response to reactive hyperemia. Correlation of EDV with clinical symptoms of SV was found. CONCLUSION: In SV changes in EDV and EIV as well as CS are caused by endothelial dysfunction. CS serves as an additional criterion of endothelial function impairment in unaffected EDV Correlation of EDV changes with clinical symptoms points to pathogenetic value of endothelial dysfunction in SV.

[A study of the adhesive glycoprotein-inactivating protein from mammalian blood serum]. / Issledovanie belka-inaktivatora adgezivnogo glikoproteina iz syvorotki krovi mlekopitaiushchikh.

A protein with a molecular weight of 70 kDa was isolated from bovine blood serum and purified to a homogenous state. This protein inhibited reversibly the adhesive serum glycoprotein with a molecular weight of 12 kDa, which displayed biological activity at ultralow doses. Amino acid analysis showed that the protein inactivator belongs to the group of prealbumins from vertebrate blood serum. The secondary structure of its molecule was characterized by a considerable number of alpha-helices. The conditions for inactivation of serum glycoprotein were studied. The interaction between the serum glycoprotein and the protein inactivator occurred over a long period of time (1 day). It should be emphasized that the presence of calcium ions was a necessary condition for the inactivation of the serum glycoprotein. The data suggest that inactivation of serum glycoprotein results from the formation of a molecular complex consisting of the protein inactivator and the glycoprotein, which is related to the carbon-protein interaction.

[Diagnosis of obturator canal hernia]. / Diagnostika gryzhi zapiratel'nogo kanala.

The canalis obturatorius hernia was revealed in 3 women aged 74-84 yrs old of 221 patients who have died due to strangulation of hernia. Diffuse peritonitis, caused by an acute strangulation ileus, was the reason of the death. Osteometric investigations were performed in 50 cadavers. For the improvement of the canalis obturatorius hernia diagnosis there was proposed the application of dots of its projection.

The chemical modification of alpha-chymotrypsin with both hydrophobic and hydrophilic compounds stabilizes the enzyme against denaturation in water-organic media.

We considered alpha-chymotrypsin (CT) in homogeneous water-organic media as a model system to examine the influence of enzyme chemical modification with hydrophilic and hydrophobic substances on its stability, activity and structure. Both types of modifying agents may lead to considerable stabilization of the enzyme in water-ethanol and water-DMF mixtures: (i) the range of organic cosolvent concentration at which enzyme activity (Vm) is at least 100% of its initial value is broadened and (ii) the range of organic cosolvent concentration at which the residual enzyme activity is observed is increased. We found that for both types of modification the stabilization effect can be correlated with the changes in protein surface hydrophobicity/hydrophilicity brought about by the modification. Circular dichroism studies indicated that the effects of these two types of modification on CT structure and its behavior in water-ethanol mixtures are different. Differential scanning calorimetry studies revealed that after modification two or three fractions or domains, differing in their stability, can be resolved. The least stable fractions (or domains) have properties similar to native CT.